• "The problem when so much dopamine is being released at once is that all the other common pleasure-generating activities of life start to feel dull and non-motivating. The brain has been sort of "hi-jacked" by the addictive behavior that produces so much dopamine and pleasure. The brain starts to perceive these addicted behaviors as essential to survival like eating and drinking and will do everything to favor and privilege the addiction over everything else...Finding activities that can release a similar amount [dopamine] is not easy. The most common are drugs, alcohol, gambling, sex." - Bordeaux, P. (2008). Gov. Eliot Spitzer's addiction. Forbes.com. Retrieved March 13, 2008, http://www.forbes.com/2008/03/12/spitzer-addictive-behavior-oped.
• Miller, W.R. (1977). The Addictive Behaviors: Treatment of Alcoholism, Drug Abuse, Smoking, and Obesity.
• Orford, J. (1985). Excessive Appetites; a psychological view of addictions.
• Milkman, H. and Sunderwirth, S. (1987). Craving for Ecstacy: How Our Passions Become Addictions and What We Can Do About Them.
• L'Abate, L. (1991). Handbook of Differential Treatments for Addictions.
• Heubner, H. (1993). Eating Disorders and Other Addictive Behaviors.
• Coombs, R. H. (2004). Handbook of Addictive Disorders: A Practical Guide to Diagnosis and Treatment.
• Freimuth, M. (2005). Hidden Addictions.

• "The problem is that it has become fashionable to regard whatever we feel inside as the true voice of nature speaking. The only authority many people trust today is instinct. If something feels good, if it is natural and spontaneous, then it must be right. But when we follow suggestions of genetic and social instructions without question we relinquish the control of consciousness and become helpless playthings of impersonal forces. The person who cannot resist food or alcohol, or whose mind is constantly focused on sex, is not free to direct his or her psychic energy." - Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York: HarperPerennial. Pg. 18.

Sexberoende personer har ett genetiskt anlag att utveckla beroende

• Carnes, P. J. (1991). Don't call it love: Recovery from sexual addiction. Chapter 4. New York: Bantam.
• "Tiny differences in genes we have in common make some of us more vulnerable to breast cancer, alcoholism or infections..." - Holtz, R. L. (March 21, 2008). Tiny gene variations can even alter effect of the pills we take [Electronic version]. Science Journal, B1.

• "Our knowledge of drug taking, gambling, television watching, and consuming behavior in general must lead us to expect that the availability of a reinforcing activity will result in the population distributing themselves along a skewed frequency distribution curve. Whatever the activity, the majority engage in it in moderation or not at all. Fewer and fewer people do more and more of it. Very heavy, frequent, or immoderate indulgences in the activity is abnormal only in the statistical sense, but almost always carries greater risk of the incurring of various "costs" (loss of time, loss of money, social rule-brealing, bodily damage, impairment of performance, etc.)... it would be most surprising if there were no dissonant or "compulsive" heterosexuals.” (Orford, 1978.)
• Orford, J. (1978). Hypersexuality: Implications for a theory of dependence. British Journal of Addiction, 73, 299-310.
• Philaretou, A. G., Mahfouz, A. Y., & Allen, K. R. (2005). Use of Internet pornography and men's well-being. International Journal of Men's Health, 4, 149-169.
• Delmonico, D. L. & Miller, J. A. (2003). The Internet sex screening test: A comparison of sexual compulsives versus non-sexual compulsives. Sexual and Relationship Therapy, 18, 261-276.
• Putnam, D. E. (2000). Initiation and maintenance of online sexual compulsivity: Implications for assessment and treatment. CyberPsychology & Behavior, 3(4), 553-563.
• Dodes, L. D. (1994). Compulsion or addiction. JAPA, 44(3), 815-835.
• Hayaki, J., Anderson, B., and Stein, M. (2006). Sexual risk behaviors among substance users: Relationship to impulsivity. Psychology of Addictive Behaviors, 20(3), 328-332.
• Teicher, M. H. (2007). Childhood abuse, brain development and impulsivity. MASOC/MATSA Joint Conference. http://www.mclean.harvard.edu/research/clinicalunit/dbrp/seminars.php

• "What happens physically is that the prefrontal cortex—the part of the brain responsible for making wise decisions and considering the eventual future consequences of a particular behavior—becomes overpowered by the limbic system. The cortex, the sort of "conductor" of the brain's orchestra, is no longer in charge, losing it's ability to control the pleasure-seeking limbic area in its insatiable search for pleasure." - Bordeaux, P. (2008). Gov. Eliot Spitzer's addiction. Forbes.com. Retrieved March 13, 2008, http://www.forbes.com/2008/03/12/spitzer-addictive-behavior-oped.

Referenser
• The Betty Ford Institute Consensus Panel. (2007). What is recovery? A working definition from the Betty Ford Institute. Journal of Substances Abuse Treatment, 33, 221 - 228.
• Kelly, J. F. & Myers, M. G. (2007). Adolescents' participation in Alcoholics Anonymous and Narcotics Anonymous: review, implications and future directions. Journal of Psychoactive Drugs, 39(3), 259-269.
• Laudet, A. Stanick, V. & Sands, B. (2007). An exploration of the effect of on-site 12-Step meetings on post-treatment outcomes among polysubstance-dependent outpatient clients. Evaluation Review, 31(6), 613.
• Johnson, J. E., Finney, J. W. & Moos, R. H. (2006). End-of-treatment outcomes in cognitive-behavioral treatment and 12-step substance use treatment programs: Do they differ and do they predict 1-year outcomes? Journal of Substance abuse Treatment, 31(1), 41-51.
• Donovan, D. M. & Wells, E. A. (2007). Report; 'Tweaking 12-Step': the potential role of 12-Step self-help group involvement in methamphetamine recovery. Addiction, 102(1), 121
• "Addicts arrive at the doorstep of a Twelve Step program convinced they are unique in their badness, telling themselves, "No one has been as bad or as out of control as I have. No one would accept me or care for me." Being accepted in the fellowship, they learn through stories that they have an illness which in fact is common. What has been shrouded in agonizing secrecy for years becomes openly talked about. In working the first step, addicts admit that they, too - like all these other people - have become powerless over their illness." - Carnes, P. J. (1989). Contrary to Love. Pg. 163
• "The most important requirement for an effective metaphor is that it meet the client at his model of the world. That does not mean that the content of the metaphor is necessarily the same as that of the client's situation. "Meeting the client at his model of the world" means that the metaphor preserves the structure of the client's problematic situation. That is, the significant factors in the metaphor are the client's interpersonal relationships and patterns of coping within the context of the "problem," The context itself is not important." - Gordon, D. (1978). Therapeutic Metaphors. Cupertino, CA: META. Pg. 24.
• "With the secrecy and shame of the core beliefs alleviated by the program (12 STEP), the ability to incorporate new core beliefs is born. Other interventions in the addictive system contribute to the preparation of the new beliefs. Few have more significance than how the program helps addicts with their impaired thinking." - Carnes, P. J. (1989). Contrary to Love. Pg. 164
• "... addicts in recovery go through a profound grief process, as all of them do. For the sexual addict, sex has been the primary relationship - the main source of nurturing life. The end of that relationship is like a death. The addict who stops the addictive cycle, which gave meaning and direction to life, suffers a very real loss." "The Twelve Step program helps addicts through their grieving process; it disrupts preoccupation and obsession with sex and supports grieving over the loss of the pathological relationship." - Carnes, P. J. (1989). Contrary to Love. Pg. 167-168
• "The first step of the Twelve Steps helps with the denial and isolation in several ways. Addicts admit that they are powerless over the addiction and that their lives have become unmanageable. Usually they do a methodical inventory of all the ways the addiction proved more powerful, including all those events they would have done anything to avoid but were powerless to stop. Throughout the inventory, addicts note how life had become unmanageable and intolerable with the addiction. The process helps them own their loss. They admit (powerlessness) and surrender (unmanageability) to the illness and acknowledge their need for help. Once they have acknowledged a loss, most grieving persons become very angry. ...They feel angry at God for letting this happen, anger at the addiction, anger for loss of the addiction, and anger at themselves for not having done something sooner. By taking the second and third steps, addicts make a significant act of trust, acknowledging a higher power who can help them regain sanity. They then can turn their lives over to a Higher Power. This leap of trust requires acceptance of the fundamental dependency of the human condition. The addict can then make meaning out of the experience. ...Those who suffer losses, and pass through the stages of denial and anger, come to accept themselves through letting go...
Steps four and five help the addict bypass shame and gain self-acceptance. Step four asks addicts to make a thorough inventory of personal strengths and weaknesses, including all the ways they have not lived up to personal values. This careful look at themselves may cause sadness and remorse.
Step five invites the addicts to share their inventory with another person. ...The experience of relating all that history to someone else exposes the recovering person at an extreme level of vulnerability. Being so exposed, and yet being affirmed and accepted, creates healing of the highest order. ... In effect, the addicts can feel restored to the human community. Often great joy and relief occur after the fifth step has been taken.
As in all grief, the struggle does not subside with self-acceptance. Bereaved persons have moments during which they intensely search for the lost relationship. Addicts experience pangs of loss when their sadness and their desire for the old way returns. This is a time for "slips," loss of courage, euphoric recall, and testing limits. Once again the program provides a framework to help with this hanging on of grief. Steps six and seven ask addicts to be ready to let go of the defects of character which could bring back the active addictive life. Again, part of letting go requires a trust in a Higher Power and trust in the existence of a healing process. With steps six and seven,
the program participants identify the addictive "friends" - those beliefs, defenses, attitudes, behaviors and other issues that supported the addiction when it flourished. As the grieving process evolves, a new sense of identity emerges. With restored confidence, the bereaved seek reconciliation with people they had pushed away. For addicts, the renewal of identity takes concrete forms in terms of celebrating their progress. ... Building on this renewed sense of self, the addicts' shame no longer prevents reconciliation with friends and family. With steps eight and nine, the addicts list those people who have been harmed and make amends, hopefully to heal the breach in the relationship. Making these direct efforts brings comfort through further restoration of self and, in some cases, forgiveness. ...although the sadness never leaves, it is transformed becoming incorporated into our beings as part of that suffering that brings wisdom and depth of feeling to all of us. One simply learns to adjust life in order to carry the suffering.
Step ten encourages a daily effort to take stock of one's life using the principles of the first nine steps. Step eleven suggests that spiritual progress results from a daily effort to improve conscious contact with a Higher Power. Step twelve asks addicts to tell other addicts about the power of the program. They pass on what they have received.
These last three steps help the addicts integrate the program principles into daily life, and the program thus becomes an intervening system which disrupts the addictive system and provides ongoing support for the lifelong process of surviving the loss." Carnes, P. J. (1989). Contrary to Love. Pg. 168-171.